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Thread: 10 days, and no let down

  1. #1

    Unhappy 10 days, and no let down

    Hello ladies

    This is my first time coming to this website. I am sitting here disappointed and feeling pretty down about my current breastfeeding fiasco.

    Essentially my new little girl is 10 days old. She was born full term at 8 pounds 2 ounces. she was also born vaginally. It was a slightly longer labour (28 hours), and in the end the doctor had to manually take out my placenta (trying to give the full picture).

    I had rather intense edema in my feet until today (wow, I have ankles). I have been producing VERY little milk since the little lady got here. 3 days ago I started pumping (symphony) and started taking Domperidone (I am in Canada). I have also been eating oatmeal and drinking milkmaids tea. The baby is supplemented with formula after every feeding (she had a dehydration scare and the pediatrician said this was essential). I only learned today about the medela suplementing system, and unfortunately have been using bottles. I searched my city and can't seem to find this system yet (one store has it but it is sold out, figures).

    I guess my ultimate question is do I have a chance at a normal breastfeeding relationship with my child? Is 10 days out of this world? I have no idea. And my lactation consultant is nice, but really she is more of a cheerleader then a person who has provided me with solid guidance. This is my first child.

    Any ideas would be amazing. I had a very healthy pregnancy and am a generally healthy person. I had to take iron prior to having the wee one. Other then that, I really cannot think of anything I am omitting. Absolutely any help would be unbelievably appreciated.

    I am pumping with every feeding (2 to 3 hours).

    Thank you for your time!

    S

  2. #2
    Join Date
    May 2006
    Posts
    21,236

    Default Re: 10 days, and no let down

    Welcome and congratulations on the new baby! I am sure you're in a pretty dark, self-doubting place right now, but please be assured that there is still plenty of hope for things to go in the right direction, and for you and your baby to enjoy the nursing relationship of your dreams. Lots of mamas struggle in the beginning and then go on to meet and/or exceed their breastfeeding goals. You're not alone in facing a tough situation.

    Here are some questions for you that will help us assess your situation:
    - How much formula are you currently using?
    - How much milk are you pumping per session?
    - How often are you pumping?
    - How does nursing feel? (Any pain, discomfort?)
    - Is baby sleepy at the breast? (Falls asleep rapidly when nursing)
    - Is baby jaundiced?
    - How was dehydration determined?
    - Was baby producing adequate wet and poopy diapers prior to supplementing?
    - Did you have any of the following during birth: severe blood loss, IV fluids, magnesium sulfate?
    - Ever have any breast or nipple surgeries (including implants or reduction)?
    - Did you ever see/feel your milk "come in"- you might have experienced a period of engorgement, or seen a changeover in the color of your milk from yellow (colostrum) to creamy white (early milk)?
    - Any history of thyroid problems or PCOS for you?
    - Are you currently using any form of hormonal contraception?

    Honestly, because you ended up with a manual removal of the placenta, my first instinct is to wonder if you may have a fragment of retained placenta which is inhibiting milk production. As long as there is a piece of placenta in the uterus, your body acts as if it is still pregnant and doesn't produce much milk. So one of the first things I would do is to call the ob and find out if this is a possibility. The ob should have inspected the placenta and made sure that everything came out, but it's possible that a piece got missed, particularly if the placenta did not come out all in one piece.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
    Join Date
    Jun 2008
    Location
    TX
    Posts
    2,197

    Default Re: 10 days, and no let down

    I'm so sorry you've had such a rough beginning.

    Have you had a chance to weigh your baby before and after a nursing session to see how much milk she is taking in from you? A baby is much more efficient at getting milk out than a pump is. Has she been evaluated for tongue tie and proper latch and sucking mechanics? Those can make a big difference in how much milk a baby can get. Would your daughter be willing to nurse more frequently? Perhaps taking a day or two to just lie in bed together skin-to-skin and pretty much let her stay latched on as much as she wants would help stimulate more production for you. I think you definitely do have a chance at breastfeeding success. We'll all try to help you figure out what is going on!
    Teal

    25 May 96 and 14 January 08 and 27 February 2012

  4. #4
    Join Date
    Feb 2011
    Posts
    278

    Default Re: 10 days, and no let down

    First, I totally agree with mommal , in that I would make sure there is no retained placenta. That can delay milk coming in.

    Secondly, I want to give you a little hope with my story. My milk took forever to come in. At 8 days postpartum I could hand express just droplets, not streams. My baby was dehydrated and I was nursing and then supplementing with formula. I saw an LC who thought it was my mild PCOS causing supply problems and that I would never exclusively breastfeed. I was heartbroken. Also she was a terrible LC, and had no real advice.

    On my own, I rented a hospital grade pump, a Symphony, like you have. And I obtained domperidone in the US. I cannot take reglan because I have a history of mood disorder. Within 48 hours I had milk, and a lot of it! I weaned off the dom within 2 additional weeks. My son was EBF by 14 days of age and has not had a bottle since. He was exclusively breastfed the first 6 months of his life and at 10 months is still nursing many times a day and has some solid food too. He has grown beautifully and thrived, and is 21 lbs!

    I may just write that horrible LC a letter.
    Mama to five beautiful kids- 9, 8, 3, 2 and currently nursing our new baby girl born 1/20/2013


    "It should not be necessary to tell reasonably intelligent mammals to suckle and not dismember their neonates." ~Susan Blustein

  5. #5
    Join Date
    Mar 2010
    Location
    Brussels, Belgium
    Posts
    1,302

    Default Re: 10 days, and no let down

    Melissa, what a great story, and thanks for sharing the cheer OP (I prefer that to 'milkless') it's not too late, and never to late. Here's just one piece of info the the time when you can eventually wean off supplementation:
    http://www.kellymom.com/bf/supply/decrease-formula.html
    and lots of the links on this Got Milk? page are excellent:
    http://www.kellymom.com/bf/supply/ the author is an IBCLC and very knowledgible. HTH and just keep taking steps in the right direction, you'll get there

    Oh yeah, and the Lact-Aid system I've heard is a step up from the Medela SNS as it gets baby to suck, whereas the SNS is a gravity drip-feed. You can try cup-feeding the supplements to avoid anipple preference developing and keep baby learning how to nurse from a breast. Most of the info I've read is that it's best to avoid artificial teats and nipples (including soothers) till 6-8wks.

    Dom info (from a Canuck!): http://www.breastfeedinginc.ca/conte...gename=doc-DGS

    and note he urges skin-to-skin contact as a first resort before dom. Have you tried that?
    http://www.breastfeedinginc.ca/conte...ename=doc-ISSC

    KUP on if there is a retained placenta issue. 'Milkless' the truth is your breasts work and it's some type of temporary situation that is causing the situation. Once identified it can be resolved. You can do this
    Last edited by @llli*bxlgirl; November 12th, 2011 at 05:56 AM. Reason: lact-aid
    Katharine
    Be the change you want to see in the world--Mahatma Gandhi
    mid-August DD (2010) & DS (2011 VBAC)
    Ouch! Is it thrush or Raynaud's phenomenon?

  6. #6

    Default Re: 10 days, and no let down

    To respond to some of the questions:

    Currently my little lady drinks about 2 to 3 ounces of formula after her feeding. I use up the pumped breast milk as I go. I only get about 10 ml's combined from my pumping sessions. Last night she didn't want two of her formula bottles though, but this morning she was back to guzzling it back!

    I am pumping 8 times a day perhaps more (if she is hungry on demand).

    Nursing feels great. This is the one area where there is no problem. they have looked at her latch and her tongue etc. She is a great nurser and has been from day one.

    Sometimes the baby will fall asleep at the breast. Not often "rapidly".... but sometimes. She was doing this more in the earlier days. Now she is pretty alert.

    My little lady is jaundice. She had to have phototherapy in the hospital. She doesn't warrant any treatment anymore, but yes, she is jaundice.

    Dehydration was determined at the Children's Hospital. she hadn't pee'd or pooped in 12 hours (14 by the time she finally did). Because of her jaundice they took her in right away. it turned out she was not being supplemented enough. From that day forward she is being supplemented until satiated. The initial pediatrician only wanted 15ml's of supplementing. This is what we followed until our trip to the children's hospital in my city.

    As explained above, no, the baby was not producing adequate wet and poppy diapers prior to supplementing.

    I did have slightly severe blood loss during the birth. Not sure if that had to do with the manual removal of the placenta or what it was. They advised it was nothing to worry about. I was seperated from my little girl for a while when they were dealing with the placenta and the blood loss. It did not warrant a blood transfusion. I did receive an IV during my labour as I was extremely ill (had thrown up all day).

    I have never had any breast surgeries.

    I have never "felt" my milk come in. No engorgement, no change etc. the milk I produce now is white, not yellow.

    No history of thyroid or PCOS.

    I am not using any contraceptives or hormone treatments etc.

    I would like to mention regarding my placenta, I brought this up a number of times while in the hospital. I was very worried there was placenta remaining. They advised they were sure they got all of it, and that if any small pieces were remaining, they would expel themselves through the contractions my uterus made while breast feeding. Isn't that ironic. How can I breast feed if there is no milk... to then get rid of the placenta?

    Anywho, that is my history. Still no massive flow of milk.

    Thank you everyone for your info. I just feel helpless. I want to believe this is going to happen, but frankly, I am loosing hope.

    Off to the lactation consultant today to get checked. She does weigh the baby to check and see how much she is getting. Last time is was minimal. But she had a wet diaper so it was harder for her to tell!

    Thanks again everyone!!!

    S

  7. #7
    Join Date
    May 2006
    Posts
    21,236

    Default Re: 10 days, and no let down

    Thank you for answering all those questions! To start with, if nursing feels good, that's great! That means your baby has a good latch and probably doesn't have a tongue tie, and it's excellent to have those fundamentals covered so soon in your nursing journey. No breast surgeries, no hormonal contraception, no history of PCOS- those are all great, too, since all those things can stand in the way of adequate milk production. So, need on what you've posted, the following are the avenues I would explore to explain the difficulties you've had so far:
    - Retained placenta. Yes, the hospital claimed they got it all and anything left would pass on its own- but what you're experiencing makes me doubt that. I think it makes sense to pursue this with the ob.
    - Thyroid problems. My LC said these were very common in the postpartum period, even in women with no history of thyroid issues like you. (If you'd had problems prior to pregnancy, this would be an even stronger possibility.)
    - Jaundice. Sometimes sleepy babies just don't do a good enough job at the breast of transferring milk, and that can impact mom's supply.
    - I have read here and there (sorry, I don't have references for this!) that blood loss, severe edema, and fluid overload from IV fluids can delay the onset of milk production. But if so, it seems like this should be passing by now...?
    - Trouble with the pump. A Symphony is a great pump, but maybe the shields aren't the right size? I'd pursue this with the LC.

    Please let us know how things go with the LC! One thing you might want to do is to rent a scale for home use. By doing your own weigh-feed-weigh tests, you can gain a highly accurate picture of milk intake. One weigh-feed-weigh test at the LC's office doesn't necessarily tell you what you need to know, since your baby could take in a lot more or a lot less milk than average during that single feeding.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

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